Rotator Cuff Repair of the Shoulder

Your shoulder joint

Your shoulder is made up of three bones:

The collar bone, or clavicle (KLAV-ick-ol)

The shoulder blade, or scapula (SKAPyou-luh)

The bone of the upper arm, or humerus (HYOO-mer-es)

The rounded end of the humerus is called the head. The head fits into a hollow in the scapula. The hollow is called the glenoid (GLEE-noid). The head and glenoid fit together like a ball and socket and form the shoulder joint.

What is the rotator cuff?

The rotator (ROW-tay-ter) cuff is made up of muscles and tendons that surround your shoulder joint. The 4 muscles of the rotator cuff and its tendons help to keep your shoulder steady as your arm moves.

What is a rotator cuff injury?

A rotator cuff injury is a strain or a tear of one or more of your rotator muscles or tendons. Trauma from a fall or a sports injury can cause a sudden, severe tear, which is called an acute tear. When a tear happens over time, it is called a chronic tear. Overuse, constant stress, or wear and tear from aging can cause a chronic tear.

Symptoms of an injury include:

Pain in your shoulder when you move your arm

Pain that wakes you up from a sound sleep almost every night

Weakness in your shoulder when you raise your arm

Less ability to move your shoulder and arm (called limited range of motion)

Why you need surgery

Surgery to repair the rotator cuff is necessary when you have a sudden and complete tear. Surgery may also be required if you have continuing pain and are becoming less able to move your shoulder. Surgery restores movement to your shoulder. Surgery also preserves strength of injured muscles and tendons.

During your surgery

During surgery, your rotator cuff is mended. First, a space is cleared. The torn muscle or tendon is shaved. Sacs between the tendons and bones act as a cushion. These sacs are called bursas (BER-suz). Sometimes a bursa has thickened, so it is removed. Bone at the tip of the shoulder blade may be shaved.

Some ligaments also may be removed.

Then the edges of the tear are brought together and stitched. A sterile dressing is placed over the incision. Your affected arm is placed in a sling or in a harness called a shoulder immobilizer (im-OH-bill-EYE-zer).

These devices help to keep your shoulder from moving.

After your surgery

The following list tells you what you need to know and do after your surgery.

Discomfort

Your doctor will prescribe pain medicine for you.

Your doctor may also tell you to put ice packs on your shoulder.

Care of your incision

If you have a dressing over your incision, keep the dressing clean and dry.

If your incision is open to the air, keep the area clean and dry.

If Steri-Strips tape covers your incision, keep the Steri-Strips clean and dry. They will peel off on their own.

Do not put any lotion or ointment on your incision, unless your doctor says you may.

To prevent movement

Your doctor will tell you how long to wear your sling or shoulder immobilizer. How long you need to wear it depends on the type of surgery you had.

If you wear a sling, your arm should be at a 90-degree angle at the elbow. Your wrist and hand should be supported by the sling. Do not allow your wrist and hand to hang over the sling.

If you wear a shoulder immobilizer, you may loosen the wrist strap only and straighten your lower arm at the elbow. Do not move your shoulder. Never completely remove your shoulder immobilizer until your doctor says you may.

Skin care

It is important to keep your underarm area clean and dry.

Gently clean the underarm area daily with soap and water. Lean to the side, and let your affected arm hang down. Do not raise your affected arm when you clean the underarm area.

Deodorant may be difficult to put on if you wear a shoulder immobilizer. Creamdeodorants are easier to use than stick or roll-on types.

A gauze pad placed under your arm can help absorb sweat and keep your skin from becoming irritated. Change the pad at least once a day.

Activity

Do not move your affected arm away from your body or over your head.

To make sleeping easier, raise your upper body on pillows. Do not lie flat.

If you have a sling or a shoulder immobilizer, do not shower until your doctor says you may. You should take a sponge bath (not a tub bath).

Do not lift anything with your affected arm.

Move the fingers and wrist of your affected hand 10 times an hour while you are awake.

Rehabilitation

Your doctor will talk to you about a program of rehabilitation and exercise.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

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